Tolerability of selective serotonin reuptake inhibitors in thirty-nine children under age seven: a retrospective chart review.
Tolerability of selective serotonin reuptake inhibitors in thirty-nine children under age seven: a retrospective chart review.
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三十九名七岁以下儿童选择性血清素再摄取抑制剂的耐受性：回顾性图表审查。
DOI：
10.1089/cap.2007.0086
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发表时间：
2007
影响因子：
1.9
通讯作者：
Gonzalez-Heydrich,Joseph
中科院分区：
文献类型：
--
作者：
Zuckerman,MarciaL;Vaughan,BrigidL;Whitney,Jane;Dodds,Alice;Yakhkind,Aleksandra;MacMillan,Carlene;Raches,Darcy;Pravdova,Iva;DeMaso,DavidRay;Beardslee,WilliamR;Gonzalez-Heydrich,Joseph
目的：描述7岁以下儿童开始使用选择性血清素再摄取抑制剂（SSRIs）治疗的不良反应。方法：我们对波士顿一家学术精神病学部门7岁以下开始使用SSRI治疗的所有儿童的医疗记录进行了回顾性审查。结果：39例患儿（男26例，女13例）符合纳入标准。治疗开始时平均年龄5.9±0.8岁，中位治疗时间5.0个月。SSRI治疗的目标诊断为54%的患者患有焦虑症，23%的患者患有抑郁症，20%的患者同时患有焦虑症和抑郁症。没有自杀意念或企图的报告。没有儿童因不良反应（ae）而住院。11例患者（28%）报告了中度以上严重程度的AE；7人（18%）因AE停用SSRI。6例因行为激活停药，1例因胃肠不适停药。AE发生的中位时间为23天，发作后的中位缓解时间为19天。结论：该样本中较高的不良反应率，特别是激活率，表明在幼儿中使用ssri类药物时应继续谨慎。有必要进行对照试验。
Objective:To characterize the adverse effects of treatment with selective serotonin reuptake inhibitors (SSRIs) started in children under age 7 yr.Methods:We conducted a retrospective review of medical records for all children who had begun treatment with an SSRI under age 7 at an academic psychiatry department in Boston.Results:Thirty-nine children (26 males, 13 females) met the inclusion criteria. Mean age at start of treatment was 5.9 ± 0.8 yr, and median treatment duration was 5.0 months. The target diagnoses for SSRI treatment were anxiety disorders in 54%, depressive disorders in 23%, and both anxiety and depressive disorders in 20% of patients. There were no reports of suicidal ideation or attempt. No children were medically or psychiatrically hospitalized for adverse effects (AEs). Eleven patients (28%) reported an AE of at least moderate severity; 7 (18%) discontinued the SSRI due to the AE. Six patients discontinued due to behavioral activation and 1 due to gastrointestinal upset. The median time to onset of an AE was 23 days, and median resolution was 19 days from onset.Conclusions:The high rate of adverse effects, especially activation, in this sample argues for continued caution in using SSRIs in young children. Controlled trials are warranted.